The heat gets turned up..on home birth
The American Medical Association resolved this week, in support of the previous ACOG statement on home birth, that “the safest setting for labor, delivery, and the immediate postpartum period is in the hospital or in a birthing center within a hospital complex or a free-standing birthing center (that meet standards)”. The AMA takes the ACOG statement one step further in resolving that the AMA develop model legislation based on the concept that the safest setting for birth is the hospital or birthing center, not home.
I had two thoughts when I read this news on AOL. First, that Ricki Lake’s The Business of Being Born is making waves, not just with women but with obstetricians. Big enough waves that they are gearing up to STOP home birth…in the same way they stopped it, and midwifery, a century ago, with legislation.
My second thought was about research. Mayri Sagady Leslie and Deb Wooley and I (representing the Expert Work Group of CIMS) presented The Evidence Basis of the Ten Steps of Mother Friendly Care in Glasgow, Scotland two weeks ago at the International Confederation of Midwives meeting. There were over 3000 midwives (and researchers) from 80 countries in attendance. The research presentations on home birth were excellent. Unlike at conferences in the U.S. there were so many sessions on home birth that I had a hard time deciding which sessions to attend. I spent time talking with midwives from the U.K. who do home births as well as hospital births…all the time. A keynote address by a midwife at a large London hospital talked about how they have worked toward acheiving their goal of increasing the number of normal births…by increasing access to home birth. In some parts of London 20-30% of the women have planned home births. I also spent time with Dutch midwives. In the Netherlands home birth never disappeared, and although the number of planned home births has decreased, it is still about 30% of all births. I met Ken Johnson and Betty-Anne Daviss, whose groundbreaking research on home birth in North America was published in the British Medical Journal. We spent several hours discussing why, when the research is so supportive of both the safety and value of home birth, there is so much resistance from the medical establishment in the U. S., in stark contrast to other parts of the world.
The media reported that Ricki Lake’s response to the AMA resolution was that women deserve to have choices. But Ricki Lake’s response to the AMA resolution hit much harder. As she does in The Business of Being Born she keeps the research and the safety of home birth in the forefront. Take a look.
Obstetricians and hospitals have not made birth safer for healthy women. Midwifery care and planned out of hospital birth increase the chances that healthy women will have normal births and healthy babies (that don’t have to spend 24 hours in the NICU for observation). It’s time for women, and childbirth educators, and nurses, and midwives, and doulas to join Ricki Lake in getting the word out…not only do women deserve real choice, but we also deserve care that is safe. And, that is not what is on offer in most hospitals today.
June 27th, 2008 at 8:05 pm
I’ve been reading the blogs on this. Very frightening, but we have lots of great, educated women in the ranks to take this on. Onward!
July 3rd, 2008 at 10:49 am
I AM A CNM WHO HAS BEEN PRACTICING FOR 31 YEARS DOING BOTH HOME AND HOSPITAL BIRTHS. IT IS THE VERY POLICIES AND PROCEDURES THAT HOSPITALS REQUIRE THAN MAKE HOSPITAL BIRTHS MORE DANGEROUS THAN HOME BIRTHS. THERE ALWAYS HAS AND ALWAYS WILL BE HOME BIRTHS- WITH LAWS AND RESTRICTIONS BY GOVERMENT HOMEBIRTHS WILL INDEED BECOME MORE DANGEROUS AS LESS EXPERIENCED PROVIDERS WILL BE ASSISTING AT THESE DELIVERIES. THIS WILL PROVE THE POINT THE GOVERMENT DESIRES- HOME BIRTHS ARE NOT SAFE.
July 12th, 2008 at 9:52 pm
I am convinced this is another show of trying to keep women in the submissive role.
Ban home birth as an option: effectively limiting women’s choice.
Ban midwives from practicing more independently: effectively limiting women’s choices.
Prevent anyone in the hospital setting from being called “Dr.”: just more proof the nurses going to get their Doctorates are making these physicians nervous, and so the effect of them trying to push for no reference to the educational title is so no woman will realize they have a choice of providers. This effectively will limit women’s choices.
The statement to say only Birth Centers established with hospitals or in-hospital births are going to be considered “safe”: this effectively also denies women a choice.
Ugh! It makes me sick to think that when we midwives gave up our own education on how to use forceps over to the physicians back well over a century ago, it has been a fight for our survival and for women’s choices ever since.
I am furious with this current mentality from the AMA, and even AGOG. They should be ashamed.
Signed: A CNM with 11 years of practice, and still counting but tired of having to fight the fight all the time.
August 24th, 2008 at 9:11 pm
I am struck by Kathleen’s comment that ” It is the very policies and procedures that hopitals require that make hospital births mor dangerous than home birth.” I couldn’t agree more. And I am stuck by Sharon’s comments..a CNM with 11 years of practice but tired of fighting the good fight all the time.
To both of you..kudos for fighting the good fight!!! For understanding the influence of hospital practices on women’s ability to give birth normally…and having the fortitude, the courage, the guts, to fight the system so that women have a fighting chance to give birth normally.
September 13th, 2008 at 6:56 pm
I always enjoy reading Judy Lothian’s calm responses to dramatic controversy around birth and breastfeeding. It’s very hard for me to understand the strong need of ACOG and the AMA to control women, which is how I perceive they are reacting to home birth. 31 years ago I gave birth safely to my daughter at home. A few months ago she gave birth safely to her son at home. Neither one of us would take chances with our own or our babies’ health, and in fact felt we were making the safer choice. My daughter had much more evidence to back her choice than I did. Thank you Lamaze Int’l and fellow members for continuing to peacefully educate all about normal birth and breastfeeding.